Abstract
From 2008 to 2010, there were 319,775 ILI inpatient cases, of which 8.82% entered ICU and 3.83% died at hospital discharge. The significant comorbidity attributes varied in each age stratum: heart failure in any age, non-dialyzed renal insufficiency in any age, cancer in school-age children up to mid-age adults, tuberculosis in the elderly, stroke in adults, congenital anomaly in children and adolescents, transplant in school-age up to adolescents, or HIV in young adults. Comorbidity vector was (heart failure, non-dialyzed renal insufficiency, cancer, tuberculosis, stroke, congenital anomaly, transplant, HIV). Age vector was (1, 1, 6<=age<45, 75<=age, 18<=age<65, 0<age<=18, 6<=age<18, 18<=age<45). Comorbidity score, the dot product of comorbidity vector and age vector, showed significant correlation with hospitalization cost (Spearman rho=0.1885, p<0.0001), and with LOS (Spearman rho=0.1717, p<0.0001). Its ROC area-under-curves (AUC) were 0.7454 with death and 0.6840 with ICU. The risk estimation model could facilitate us to address population measures for upcoming severe influenza epidemics, and further allocate resources optimally.
Highlights
Influenza-like illness (ILI) is often the initial presentation of influenza for practicing clinicians
From 2008 to 2010, there were 319,775 influenza-like illness (ILI) inpatient cases, of which 8.82% entered intensive care unit (ICU) and 3.83% died at hospital discharge
Univariate and multivariate analyses were done with the dependent variables as worse outcome, and the comorbidity attributes as covariates with the adjustment for gender in pre-defined age strata
Summary
Identification of high-risk severe cases from influenza-like illness (ILI) is crucial for disease surveilance and clinical management. The study utilized Taiwanese National Health Insurance Database, ICD-9, and Marsden-Haug’s ILI Codes to measure the effect of systemic classes of comorbidity on four outcomes: ospitalization cost, length of stay (LOS), death, and intensive care unit (ICU) entry. The significant comorbidity attributes varied in each age stratum: heart failure in any age, non-dialyzed renal insufficiency in any age, cancer in. School-age children up to mid-age adults, tuberculosis in the elderly, stroke in adults, congenital anomaly in children and adolescents, transplant in school-age up to adolescents, or HIV in young adults. Comorbidity vector was (heart failure, non-dialyzed renal insufficiency, cancer, tuberculosis, stroke, congenital anomaly, transplant, HIV). The risk estimation model could facilitate us to address population measures for upcoming severe influenza epidemics, and further allocate resources optimally
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